# MERIT DENTAL MICHIGAN PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Merit Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952737538
- **Authorized official:** JEFFREY MOOS DDS (OWNER)
- **Authorized official phone:** (715) 926-5050

## Contact information

- **Practice address:** 3060 W CENTRE AVE OFC B, PORTAGE, MI 49024-4825
- **Practice address phone:** (715) 926-5050
- **Mailing address:** 680 HEHLI WAY, MONDOVI, WI 54755-1639
- **Mailing address phone:** (715) 926-5050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2013
- **Last updated:** 09/16/2013